Basic Information
Provider Information
NPI: 1811984909
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EISER-ZWALL
FirstName: CAROL
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: EISER
OtherFirstName: CAROL
OtherMiddleName: ANN
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: CRNA
OtherLastNameType: 1
Mailing Information
Address1: 1205 LANGHORNE NEWTOWN RD
Address2:  
City: LANGHORNE
State: PA
PostalCode: 190471219
CountryCode: US
TelephoneNumber: 2157102196
FaxNumber: 2157102408
Practice Location
Address1: 1205 LANGHORNE NEWTOWN RD
Address2:  
City: LANGHORNE
State: PA
PostalCode: 190471219
CountryCode: US
TelephoneNumber: 2157102196
FaxNumber: 2157102408
Other Information
ProviderEnumerationDate: 10/04/2005
LastUpdateDate: 01/11/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XRN246187LPAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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